title: Ultrasound-guided single shot caudal block anesthesia reduces postoperative urinary catheter-induced discomfort.
abstract: BACKGROUND
  Urinary catheter-induced discomfort during the postoperative period can be distressing, and sometimes results in severe restlessness and agitation, especially in middle-aged and elderly male patients. Recent advances in ultrasound technology have increased the consistency, safety, and ease of a caudal block even in older patients. We speculated that an ultrasound-guided caudal block would be reliable and safe as treatment for such postoperative discomfort.
  
  
  METHODS
  Adult male patients (ASA I-II) undergoing cervical laminoplasty were allocated to either the caudal block (CB, N.=24) or non-block (NB, N.=24) group. Following anesthesia induction, urinary catheterization was performed using a 16 French Foley catheter. Thereafter, an ultrasound-guided caudal block was performed with 8 ml of 0.3% ropivacaine and 100 µg of fentanyl for patients in group CB, while group NB did not receive a caudal block. We assessed urinary catheter-induced discomfort as mild, moderate, or severe at 0, 2, 6, 10, and 18 hours after surgery, and compared the incidence and severity of discomfort between the groups using a randomized double-blind design.
  
  
  RESULTS
  All caudal blocks were successfully performed with 1 or 2 needle insertions. The incidence of urinary catheter-induced discomfort was significantly reduced in group CB as compared to NB at 0, 2, and 6 hours, while severity was also reduced at 0 and 2 hours. No patient required re-catheterization due to urinary retention after catheter removal. There were no other complications related to the caudal block.
  
  
  CONCLUSIONS
  Preoperative ultrasound-guided single shot caudal block anesthesia safely reduced postoperative urinary catheter-induced discomfort in our male patients.
authors.forename: M
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Y
authors.initials: Y
authors.lastname: Kyoh
authors.forename: K
authors.initials: K
authors.lastname: Mizutani
authors.forename: J
authors.initials: J
authors.lastname: Yamashita
authors.forename: T
authors.initials: T
authors.lastname: Hamada
mesh_terms: D000328:Adult; D000368:Aged; D000763:Anesthesia, Caudal / Q000379:methods*; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D018084:Ultrasonography, Interventional / Q000379:methods*; D014546:Urinary Catheterization / Q000009:adverse effects*